National Provider Identifier [NPI]: |
1124232137 |
Last Name Of The Provider |
LOSAVIO |
First Name Of The Provider |
PHILLIP |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1611 W HARRISON ST |
Street Address 2 Of The Provider |
SUITE 550 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606124861 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
1645 |
Number Of Medicare Beneficiaries |
578 |
Total Submitted Charge Amount |
684074 |
Total Medicare Allowed Amount |
156336.81 |
Total Medicare Payment Amount |
117118.66 |
Total Medicare Standardized Payment Amount |
107647.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
1645 |
Number Of Medicare Beneficiaries With Medical Services |
578 |
Total Medical Submitted Charge Amount |
684074 |
Total Medical Medicare Allowed Amount |
156336.81 |
Total Medical Medicare Payment Amount |
117118.66 |
Total Medical Medicare Standardized Payment Amount |
107647.23 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
128 |
Number Of Beneficiaries Age 65 to 74 |
250 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
353 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
297 |
Number Of Black or African American Beneficiaries |
188 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
375 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.5603 |